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“Intraperitoneal Glucose Sensing is Sometimes Surprisingly Rapid”

Authors: Anders Lyngvi Fougner, Konstanze Kölle, Nils Kristian Skjærvold, Nicolas-Andreas L. Elvemo, Dag Roar Hjelme, Reinold Ellingsen, Sven Magnus Carlsen and Øyvind Stavdahl,
Affiliation: NTNU, Department of Engineering Cybernetics, Central Norway Regional Health Authority, NTNU, St Olavs Hospital, Trondheim, Norway and GlucoSet AS, Norway
Reference: 2016, Vol 37, No 2, pp. 121-131.

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Keywords: Diabetes, Artificial Pancreas, Closed-loop systems, Type 1 diabetes, Type 2 diabetes

Abstract: Rapid, accurate and robust glucose measurements are needed to make a safe artificial pancreas for the treatment of diabetes mellitus type 1 and 2. The present gold standard of continuous glucose sensing, subcutaneous (SC) glucose sensing, has been claimed to have slow response and poor robustness towards local tissue changes such as mechanical pressure, temperature changes, etc. The present study aimed at quantifying glucose dynamics from central circulation to intraperitoneal (IP) sensor sites, as an alternative to the SC location. Intraarterial (IA) and IP sensors were tested in three anaesthetized non-diabetic pigs during experiments with intravenous infusion of glucose boluses, enforcing rapid glucose level excursions in the range 70--360 mg/dL (approximately 3.8--20 mmol/L). Optical interferometric sensors were used for IA and IP measurements. A first-order dynamic model with time delay was fitted to the data after compensating for sensor dynamics. Additionally, off-the-shelf Medtronic Enlite sensors were used for illustration of SC glucose sensing. The time delay in glucose excursions from central circulation (IA) to IP sensor location was found to be in the range 0--26 s (median: 8.5 s, mean: 9.7 s, SD 9.5 s), and the time constant was found to be 0.5--10.2 min (median: 4.8 min, mean: 4.7 min, SD 2.9 min). IP glucose sensing sites have a substantially faster and more distinctive response than SC sites when sensor dynamics is ignored, and the peritoneal fluid reacts even faster to changes in intravascular glucose levels than reported in previous animal studies. This study may provide a benchmark for future, rapid IP glucose sensors.

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BibTeX:
@article{MIC-2016-2-4,
  title={{Intraperitoneal Glucose Sensing is Sometimes Surprisingly Rapid}},
  author={Fougner, Anders Lyngvi and Kölle, Konstanze and Skjærvold, Nils Kristian and Elvemo, Nicolas-Andreas L. and Hjelme, Dag Roar and Ellingsen, Reinold and Carlsen, Sven Magnus and Stavdahl, Øyvind},
  journal={Modeling, Identification and Control},
  volume={37},
  number={2},
  pages={121--131},
  year={2016},
  doi={10.4173/mic.2016.2.4},
  publisher={Norwegian Society of Automatic Control}
};

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